AIM:To establish the frequency of hyperphosphate-mia following the administration of sodium phosphate laxatives in low-risk patients. METHODS:One hundred consecutive ASAⅠ-Ⅱindividuals aged 35-74 years,who were under...AIM:To establish the frequency of hyperphosphate-mia following the administration of sodium phosphate laxatives in low-risk patients. METHODS:One hundred consecutive ASAⅠ-Ⅱindividuals aged 35-74 years,who were undergoing colonic cleansing with oral sodium phosphate(OSP) before colonoscopy were recruited for this prospective study.Exclusion criteria:congestive heart failure, chronic kidney disease,diabetes,liver cirrhosis,intestinal obstruction,decreased bowel motility,increased bowel permeability,and hyperparathyroidism.The day before colonoscopy,all the participants entered a 24-h period of diet that consisted of 4 L of clear fluids with sugar or honey and 90 mL(60 g)of OSP in two 45-mL doses,5 h apart.Serum phosphate was measured before and after the administration of the laxative. RESULTS:The main demographic data(mean±SD) were:age,58.9±8.4 years;height,163.8±8.6 cm; weight,71±13 kg;body mass index,26±4;women, 66%.Serum phosphate increased from 3.74±0.56 to 5.58±1.1 mg/dL,which surpassed the normal value (2.5-4.5 mg/dL)in 87%of the patients.The highest serum phosphate was 9.6 mg/dL.Urea and creatinine remained within normal limits.Post-treatment OSP se-rum phosphate concentration correlated inversely with glomerular filtration rate(P<0.007,R 2=0.0755),total body water(P<0.001,R 2=0.156)and weight(P< 0.013,R 2=0.0635). CONCLUSION:In low-risk,well-hydrated patients, the standard dose of OSP-laxative-induced hyperphos-phatemia is related to body weight.展开更多
AIM:To study the efficacy and safety of pharmacolo-gical treatment of constipation in geriatrics.METHODS:Pub Med,MEDLINE,google scholar,and Ovid were searched to identify human studies performed on the use of laxative...AIM:To study the efficacy and safety of pharmacolo-gical treatment of constipation in geriatrics.METHODS:Pub Med,MEDLINE,google scholar,and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation,which were conducted between January1990 and January 2013 using the specified keywords.Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included.Studies were excluded from this review if they were non-controlled trials,case series,or case reports.RESULTS:Out of twenty three studies we initially retrieved in our search,only nine studies met the eligibility criteria of being controlled trials within geriatrics.The laxatives examined in the nine studies were senna,lactulose,sorbital,polyethylene glycol(PEG),lubiprostone,linaclotide,and prucalopride.In those studies,senna combinations had a higher efficacy than sorbitol or lactulose as well as,a very good adverse effect profile.PEG was also shown to be safe and effective in geriatric population.Furthermore,it has been shown that PEG is as safe in geriatrics as in general population.New agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrant further investigation.CONCLUSION:Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation.展开更多
Background: To reduce patients’ unnecessary suffering, Opioids Induced Constipation (OIC) should be identified and treated as early as possible with the most current treatment. Aims: to investigate the effectiveness ...Background: To reduce patients’ unnecessary suffering, Opioids Induced Constipation (OIC) should be identified and treated as early as possible with the most current treatment. Aims: to investigate the effectiveness of prophylactic laxatives in reducing the severity of OIC and its impact on cancer patients’ quality of life. Methods: A Randomized Clinical Trial design was used. 57 cancer patients from one oncology clinic at a governmental hospital participated in the study. Patients in the intervention groups were given an oral colonic stimulant laxative (i.e. Bisacodyl, Dose = 3 tab/day) or an oral colonic osmotic laxative (i.e. Lactulose, Dose = 15 ml three times per day), while patients in the control continue receiving their routine care as usual. Results: A significant decrease in the severity of constipation symptoms among the intervention group at four weeks post-intervention was noted (p Conclusions: It can be concluded that the use prophylactic of first line laxatives concurrently with opioids decreased the severity of OIC and improved the QOL for cancer patients.展开更多
AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use ...AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use for flexible sigmoidoscopy or colonoscopy, as well as which laxatives can be used safely.METHODS： Surveys were mailed to all attending gastroenterologists （n = 53） and obstetricians （n = 99） at our institution. Each survey consisted of the 14 most common laxative or motility agents used in pregnancy and inquired about the physician＇s prescribing habits in the past as well as their willingness to prescribe each medication in the future. The survey also listed four common bowel preparations used prior to colonoscopy and sigmoidoscopy and asked the physician to rank the order of the preferred agent in each case.RESULTS： With regard to common laxatives, both gastroenterologists and obstetricians favor the use of Metamucil, Colace, and Citrucel. Both groups appear to refrain from using Fleets Phosphosoda and Castor oil. Of note, obstetricians are less inclined to use PEG solution and Miralax, which is not the case ,with gastroenterologists. In terms of comparing bowel preparations for colonoscopy, 50% of gastroenterologists prefer to use PEG solution and 50% avoid the use of Fleets Phosphosoda. Obstetricians seem to prefer Fleets Phosphosoda （20%） and tend to avoid the use of PEG solution （26%）. With regard to bowel preparation for sigmoidoscopy, both groups prefer Fleets enema the most （51%）, while magnesium citrate is used least often （38%）.CONCLUSION： It is clear that preferences in the use of bowel cleansing preparations between the two groups exist, but there have not been many case controlled human studies in the pregnant patient that give clear cut indications for using one versus another drug. In light of the challenge of performing controlled trials in pregnant women, more extensive surveys should be undertaken to gather a larger amount of data on physicians＇ experiences and individual preferences.展开更多
Aim: To analyse whether there are changes in sodium and potassium serum levels during chronic treatment with the diphenyl methanes bisacodyl and sodium picosulfate. Methods: A literature search was done using PubMed, ...Aim: To analyse whether there are changes in sodium and potassium serum levels during chronic treatment with the diphenyl methanes bisacodyl and sodium picosulfate. Methods: A literature search was done using PubMed, and the reference lists of pertinent papers were screened for additional studies. Only studies of at least 4 weeks duration were considered for further analysis. Results: Four relevant studies were identified. In three randomised controlled trials with 5 to 10 mg daily of bisacodyl or sodium picosulfate, respectively, over four weeks no electrolyte losses were found. Hypokalemia was also not a problem in a group of patients with paraplegia using bisacodyl suppositories for 2 to 34 years. Conclusions: Electrolyte losses, particularly hypokalemia, are not a problem when bisacodyl or sodium picosulfate are used long-term.展开更多
BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridd...BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridden patients,but can also affect those with specific gastrointestinal dysfunctions.Diagnosing SBBO is challenging due to its clinical presentation,which mimics other intestinal obstructions.While surgical intervention is the typical treatment for SBBO,advancements in endo-scopic techniques have led to increased use of non-surgical methods,such as endoscopic lithotripsy.CASE SUMMARY We report a case of small bowel obstruction induced by a phytobezoar.A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting,abdominal distension,and constipation.Computed tomography revealed a small bowel obstruction with foreign bodies.Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen.The bezoar was successfully fragmented using a snare,and the fragments were treated with 100 mL of paraffin oil to facilitate their passage.This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation,diagnostic process,and treatment outcomes of a patient with SBBO.Special attention is given to the application and effectiveness of non-surgical treatment methods,along with strategies to optimize patient manage-ment.CONCLUSION Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.展开更多
Integrable systems play a crucial role in physics and mathematics.In particular,the traditional(1+1)-dimensional and(2+1)-dimensional integrable systems have received significant attention due to the rarity of integra...Integrable systems play a crucial role in physics and mathematics.In particular,the traditional(1+1)-dimensional and(2+1)-dimensional integrable systems have received significant attention due to the rarity of integrable systems in higher dimensions.Recent studies have shown that abundant higher-dimensional integrable systems can be constructed from(1+1)-dimensional integrable systems by using a deformation algorithm.Here we establish a new(2+1)-dimensional Chen-Lee-Liu(C-L-L)equation using the deformation algorithm from the(1+1)-dimensional C-L-L equation.The new system is integrable with its Lax pair obtained by applying the deformation algorithm to that of the(1+1)-dimension.It is challenging to obtain the exact solutions for the new integrable system because the new system combines both the original C-L-L equation and its reciprocal transformation.The traveling wave solutions are derived in implicit function expression,and some asymmetry peakon solutions are found.展开更多
The clinical application and basic research of Draba nemerosa Hebecarpa jujube diarrhoea lung soup focus on respiratory diseases and circulatory diseases, and its clinical application is more compared with the basic r...The clinical application and basic research of Draba nemerosa Hebecarpa jujube diarrhoea lung soup focus on respiratory diseases and circulatory diseases, and its clinical application is more compared with the basic research, and Draba nemerosa Hebecarpa jujube diarrhoea lung soup is mostly used in the form of “Draba nemerosa Hebecarpa Hebecarpa jujube diarrhoea lung soup with additional subtractions or other formulas combining Draba nemerosa Hebecarpa Hebecarpa Hebecarpa jujube diarrhoea lung soup” in the clinical application. This article will focus on the main mechanisms of Draba nemerosa Hebecarpa jujube diarrhoea lung soup and its main components in the treatment of respiratory and circulatory diseases, and will give a review of the basic research on Draba nemerosa Hebecarpa Hebecarpa jujube diarrhoea lung soup as follows.展开更多
We present an eight component integrable Hamiltonian hierarchy, based on a reduced seventh order matrix spectral problem, with the aim of aiding the study and classification of multicomponent integrable models and the...We present an eight component integrable Hamiltonian hierarchy, based on a reduced seventh order matrix spectral problem, with the aim of aiding the study and classification of multicomponent integrable models and their underlying mathematical structures. The zero-curvature formulation is the tool to construct a recursion operator from the spatial matrix problem. The second and third set of integrable equations present integrable nonlinear Schrödinger and modified Korteweg-de Vries type equations, respectively. The trace identity is used to construct Hamiltonian structures, and the first three Hamiltonian functionals so generated are computed.展开更多
The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecati...The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.展开更多
文摘AIM:To establish the frequency of hyperphosphate-mia following the administration of sodium phosphate laxatives in low-risk patients. METHODS:One hundred consecutive ASAⅠ-Ⅱindividuals aged 35-74 years,who were undergoing colonic cleansing with oral sodium phosphate(OSP) before colonoscopy were recruited for this prospective study.Exclusion criteria:congestive heart failure, chronic kidney disease,diabetes,liver cirrhosis,intestinal obstruction,decreased bowel motility,increased bowel permeability,and hyperparathyroidism.The day before colonoscopy,all the participants entered a 24-h period of diet that consisted of 4 L of clear fluids with sugar or honey and 90 mL(60 g)of OSP in two 45-mL doses,5 h apart.Serum phosphate was measured before and after the administration of the laxative. RESULTS:The main demographic data(mean±SD) were:age,58.9±8.4 years;height,163.8±8.6 cm; weight,71±13 kg;body mass index,26±4;women, 66%.Serum phosphate increased from 3.74±0.56 to 5.58±1.1 mg/dL,which surpassed the normal value (2.5-4.5 mg/dL)in 87%of the patients.The highest serum phosphate was 9.6 mg/dL.Urea and creatinine remained within normal limits.Post-treatment OSP se-rum phosphate concentration correlated inversely with glomerular filtration rate(P<0.007,R 2=0.0755),total body water(P<0.001,R 2=0.156)and weight(P< 0.013,R 2=0.0635). CONCLUSION:In low-risk,well-hydrated patients, the standard dose of OSP-laxative-induced hyperphos-phatemia is related to body weight.
文摘AIM:To study the efficacy and safety of pharmacolo-gical treatment of constipation in geriatrics.METHODS:Pub Med,MEDLINE,google scholar,and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation,which were conducted between January1990 and January 2013 using the specified keywords.Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included.Studies were excluded from this review if they were non-controlled trials,case series,or case reports.RESULTS:Out of twenty three studies we initially retrieved in our search,only nine studies met the eligibility criteria of being controlled trials within geriatrics.The laxatives examined in the nine studies were senna,lactulose,sorbital,polyethylene glycol(PEG),lubiprostone,linaclotide,and prucalopride.In those studies,senna combinations had a higher efficacy than sorbitol or lactulose as well as,a very good adverse effect profile.PEG was also shown to be safe and effective in geriatric population.Furthermore,it has been shown that PEG is as safe in geriatrics as in general population.New agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrant further investigation.CONCLUSION:Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation.
文摘Background: To reduce patients’ unnecessary suffering, Opioids Induced Constipation (OIC) should be identified and treated as early as possible with the most current treatment. Aims: to investigate the effectiveness of prophylactic laxatives in reducing the severity of OIC and its impact on cancer patients’ quality of life. Methods: A Randomized Clinical Trial design was used. 57 cancer patients from one oncology clinic at a governmental hospital participated in the study. Patients in the intervention groups were given an oral colonic stimulant laxative (i.e. Bisacodyl, Dose = 3 tab/day) or an oral colonic osmotic laxative (i.e. Lactulose, Dose = 15 ml three times per day), while patients in the control continue receiving their routine care as usual. Results: A significant decrease in the severity of constipation symptoms among the intervention group at four weeks post-intervention was noted (p Conclusions: It can be concluded that the use prophylactic of first line laxatives concurrently with opioids decreased the severity of OIC and improved the QOL for cancer patients.
文摘AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use for flexible sigmoidoscopy or colonoscopy, as well as which laxatives can be used safely.METHODS： Surveys were mailed to all attending gastroenterologists （n = 53） and obstetricians （n = 99） at our institution. Each survey consisted of the 14 most common laxative or motility agents used in pregnancy and inquired about the physician＇s prescribing habits in the past as well as their willingness to prescribe each medication in the future. The survey also listed four common bowel preparations used prior to colonoscopy and sigmoidoscopy and asked the physician to rank the order of the preferred agent in each case.RESULTS： With regard to common laxatives, both gastroenterologists and obstetricians favor the use of Metamucil, Colace, and Citrucel. Both groups appear to refrain from using Fleets Phosphosoda and Castor oil. Of note, obstetricians are less inclined to use PEG solution and Miralax, which is not the case ,with gastroenterologists. In terms of comparing bowel preparations for colonoscopy, 50% of gastroenterologists prefer to use PEG solution and 50% avoid the use of Fleets Phosphosoda. Obstetricians seem to prefer Fleets Phosphosoda （20%） and tend to avoid the use of PEG solution （26%）. With regard to bowel preparation for sigmoidoscopy, both groups prefer Fleets enema the most （51%）, while magnesium citrate is used least often （38%）.CONCLUSION： It is clear that preferences in the use of bowel cleansing preparations between the two groups exist, but there have not been many case controlled human studies in the pregnant patient that give clear cut indications for using one versus another drug. In light of the challenge of performing controlled trials in pregnant women, more extensive surveys should be undertaken to gather a larger amount of data on physicians＇ experiences and individual preferences.
文摘Aim: To analyse whether there are changes in sodium and potassium serum levels during chronic treatment with the diphenyl methanes bisacodyl and sodium picosulfate. Methods: A literature search was done using PubMed, and the reference lists of pertinent papers were screened for additional studies. Only studies of at least 4 weeks duration were considered for further analysis. Results: Four relevant studies were identified. In three randomised controlled trials with 5 to 10 mg daily of bisacodyl or sodium picosulfate, respectively, over four weeks no electrolyte losses were found. Hypokalemia was also not a problem in a group of patients with paraplegia using bisacodyl suppositories for 2 to 34 years. Conclusions: Electrolyte losses, particularly hypokalemia, are not a problem when bisacodyl or sodium picosulfate are used long-term.
文摘BACKGROUND Small bowel bezoar obstruction(SBBO)is a rare clinical condition characterized by hard fecal masses in the small intestine,causing intestinal obstruction.It occurs more frequently in the elderly and bedridden patients,but can also affect those with specific gastrointestinal dysfunctions.Diagnosing SBBO is challenging due to its clinical presentation,which mimics other intestinal obstructions.While surgical intervention is the typical treatment for SBBO,advancements in endo-scopic techniques have led to increased use of non-surgical methods,such as endoscopic lithotripsy.CASE SUMMARY We report a case of small bowel obstruction induced by a phytobezoar.A 49-year-old male with a history of type 2 diabetes and long-term persimmon consumption presented to the hospital with symptoms of vomiting,abdominal distension,and constipation.Computed tomography revealed a small bowel obstruction with foreign bodies.Double balloon enteroscopy identified a phytobezoar blocking the intestinal lumen.The bezoar was successfully fragmented using a snare,and the fragments were treated with 100 mL of paraffin oil to facilitate their passage.This case report aims to enhance the understanding of this rare condition by detailing the clinical presentation,diagnostic process,and treatment outcomes of a patient with SBBO.Special attention is given to the application and effectiveness of non-surgical treatment methods,along with strategies to optimize patient manage-ment.CONCLUSION Double balloon enteroscopy combined with sequential laxative therapy is an effective approach for the treatment of a breakable phytobezoar.
基金Project supported by the National Natural Science Foundation of China (Grant Nos.12275144,12235007,and 11975131)K.C.Wong Magna Fund in Ningbo University。
文摘Integrable systems play a crucial role in physics and mathematics.In particular,the traditional(1+1)-dimensional and(2+1)-dimensional integrable systems have received significant attention due to the rarity of integrable systems in higher dimensions.Recent studies have shown that abundant higher-dimensional integrable systems can be constructed from(1+1)-dimensional integrable systems by using a deformation algorithm.Here we establish a new(2+1)-dimensional Chen-Lee-Liu(C-L-L)equation using the deformation algorithm from the(1+1)-dimensional C-L-L equation.The new system is integrable with its Lax pair obtained by applying the deformation algorithm to that of the(1+1)-dimension.It is challenging to obtain the exact solutions for the new integrable system because the new system combines both the original C-L-L equation and its reciprocal transformation.The traveling wave solutions are derived in implicit function expression,and some asymmetry peakon solutions are found.
文摘The clinical application and basic research of Draba nemerosa Hebecarpa jujube diarrhoea lung soup focus on respiratory diseases and circulatory diseases, and its clinical application is more compared with the basic research, and Draba nemerosa Hebecarpa jujube diarrhoea lung soup is mostly used in the form of “Draba nemerosa Hebecarpa Hebecarpa jujube diarrhoea lung soup with additional subtractions or other formulas combining Draba nemerosa Hebecarpa Hebecarpa Hebecarpa jujube diarrhoea lung soup” in the clinical application. This article will focus on the main mechanisms of Draba nemerosa Hebecarpa jujube diarrhoea lung soup and its main components in the treatment of respiratory and circulatory diseases, and will give a review of the basic research on Draba nemerosa Hebecarpa Hebecarpa jujube diarrhoea lung soup as follows.
文摘We present an eight component integrable Hamiltonian hierarchy, based on a reduced seventh order matrix spectral problem, with the aim of aiding the study and classification of multicomponent integrable models and their underlying mathematical structures. The zero-curvature formulation is the tool to construct a recursion operator from the spatial matrix problem. The second and third set of integrable equations present integrable nonlinear Schrödinger and modified Korteweg-de Vries type equations, respectively. The trace identity is used to construct Hamiltonian structures, and the first three Hamiltonian functionals so generated are computed.
基金Supported by Associazione Italiana Gastroenterologi and Endoscopisti Digestivi Ospedalieri, Via N Colajanni, 4, 00191 Roma, ItalySocietà Italiana di Chirurgia Colo-Rettale, Via Medici, 23, 10143 Torino, Italy
文摘The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.
